Letter to Doctor Authorizing Release of Medical Records

A letter to doctor authorizing release of medical records is sent by a patient only when you want to release your all or specific private medical records to a specific concerned as mentioned by you. With the help of this letter from doctor a patient may also authorize his personal physician to release your personal private medical information and record to some other physician or organization. Generally some fee is paid by the patient to get the copy of this letter released. This is generally required when a patient transfers his medical care from one physician to another or in case when a patient wants to share his personal medical information with some individual or organization for research studies. When a patient changes his physician, the new physician definitely needs all the medical information, hospital records and history of the patients related to his medical situation.

A letter to doctor authorizing release of medical records starts with the name of the patient, complete address including house, street and city or state name. Then comes the name, designation, clinic or hospital address with complete information of street, city or state and zip code. Then next is the subject of the letter i.e. regarding authorization to release medical records for the said patient. The next thing in the Letter to doctor authorizing release of medical records is the body of the letter where the details of authorization are mentioned to guide the physician about medical information and records. And this medical letter ends with the name and signatures of the patient authorizing the doctor and name of the recipient of this letter that makes it a very good sample doctor letter.

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Letter to Doctor Authorizing Release of Medical Records

Letter to doctor authorizing release of medical records

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Health Information Release Authorization Form

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Health information release authorization form